Youth Involvement in Decision to Start CGM Linked to Consistent Use


Youth with diabetes who are involved in the decision to start continuous glucose monitoring reported consistent use 2 months after starting.

Diabetes Technology

Youth with diabetes who are involved in the decision making to initiate continuous glucose monitoring (CGM) are more likely to continue using their technology, according to a new study published in Diabetes Care.1

Previous studies have showed that youth are less likely than adults to consistently use their CGM devices, indicating a need to identify factors that could improve long-term CGM use in this patient population.

For the study, 108 parent-youth pairs from an academic endocrinology clinic completed assessments, including a measure of the child’s involvement in the decision to start CGM. After 2 months, youth completed measures of CGM self-efficacy and satisfaction, and fidelity of CGM use between weeks 5 and 12 was accessed via a cloud-based repository.

Related: COVID-19 Effect on Patients with Diabetes

The results showed that, when parents reported their children spoke up more in discussions about CGM, children used the technology more regularly up to 12 weeks after beginning use. However, when parents indicated that they themselves spoke up more in discussions about CGM, their children used the technology less frequently 2 months after starting.1

The investigators noted that children who were more involved in the discussions had stronger beliefs in their ability to use the technology successfully, and were less likely to perceive CGM as a hassle at a 2-month follow up.1

“To maximize the clinical benefits of CGM, our results suggest that providers should involve youth in the decision-making process from the beginning, eliciting their opinions, concerns, and questions about the device and providing information about the device directly to them,” Victoria A. Miller, PhD, a psychologist in the Craig-Dalsimer Division of Adolescent Medicine at Children’s Hospital of Philadelphia, said in a statement.2 “Parents also have a role to play, and providers can encourage parents to engage their children in conversations about the decision to start CGM without dominating the discussion, which may increase the likelihood that they are in agreement about waiting or proceeding.”

Related: COVID-19 Effects on Patients with Diabetes

According to the investigators, the sample population was primarily non-Hispanic white and parent participants were mostly mothers, indicating study limitations. Additionally, the study only used 1 CGM brand.2

However, they noted that additional research is warranted to develop strategies that may enhance children’s involvement in decision-making regarding CGM and increase CGM use. Further studies should include more diverse patient populations to examine the extent to which sociodemographic factors, such as race, ethnicity, and socioeconomic status, affect CGM uptake and use.2 


1. Miller VA, Xiao R, Slick N, Feudtner C, Willi SM. Diabetes Care. 2020.

2. Youth more likely to stick with CGM if they are part of decision to start. News Release. Children’s Hospital of Philadelphia; July 31, 2020. Accessed July 31, 2020.

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